We agree that the voices and experiences of people who have come into contact with the Mental Health Act (MHA), either directly or through a relative or friend, must be at the heart of the reform process. This has been the approach taken throughout. However, we do not feel that there is a need for an additional legislative mechanism for gathering the views of people who have been in hospital after they have been discharged, as proposed by the amendment. There are already a range of feedback systems, both locally and nationally, aimed at monitoring patient experience and supporting service improvements. Whilst some of these feedback mechanisms may not always be working as effectively as they could, we would prefer to focus on improving on what we currently have, rather than creating something new and risk causing confusion. We also have concerns about the practicalities of delivering this amendment. Independent Mental Health Advocates currently have no formal role in relation to people who have been discharged from the MHA and are living in the community (not including those who are subject to a community treatment order). Therefore, arranging to consult with individuals post discharge would require new systems to be put in place and significant additional resource. Advocates have also warned that a potential unintended consequence of this amendment is that patients no longer consider advocacy services to be truly independent and impartial, as they are effectively acting on behalf of the hospital to collect feedback. The amendment could therefore negatively impact the advocate’s ability to perform their core role, which is to represent and support patients whilst they are subject to the MHA. Trusted relationships between patients and advocates are critical for this to be effective. For these reasons we are rejecting the Committee’s recommendation to keep the amendment in the Bill. We recognise that a key objective of this amendment is, not only to provide feedback on inpatient services, but to create a space for the person to reflect on their detention such that they can heal from a potentially traumatic experience. Where a person has past experience of detention or admission as a voluntary patient we would expect this to form a key part of the process of making an Advance Choice Document, with the facilitation of an appropriately qualified professional. However, we think that this should be user-led and not mandated by the supporting health or care professional, as many individuals may find it traumatic to reflect on their past experiences. We do not consider Advance Choice Documents as the only opportunity for people to reflect on their experiences following their discharge. As set out in the Community Mental Health Framework, every person receiving support, care, and treatment in the community should have a co-produced and personalised care plan that takes into account all of their needs, as well as their rights under the Care Act and Section 117 of the Mental Health Act, where applicable. The care plan should include agreed timescales for review, discussed collaboratively at the outset. Reflective discussions between the individual and clinician are essential to understand what is working well and to ensure care remains responsive and personalised. We think that these forums provide a more therapeutic space for reflecting on past, potentially traumatic experiences, rather than coupling it with a feedback mechanism for making inpatient service improvements. Detaining autistic people and people with a learning disability under the Mental Health Act Committee View There is an inherent lack of justification for detaining a person for treatment based only on their learning disability or autism, giving rise to clear concerns over compatibility with Article 5 European Convention on Human Rights (ECHR). We welcome the Bill’s attempts to remove autistic people and people with learning disabilities from the scope of detention for treatment under the MHA. We recognise that the change in the law would leave open a possibility of these groups being detained on other grounds. We are pleased to see that the Government has committed to monitoring the number of autistic people and people with learning disabilities who are detained under the Mental Capacity Act. The Government should report these numbers to Parliament within a year of the relevant clauses of the Bill coming into force, and stick to their commitment to take action if they indicate that the Mental Capacity Act is being used inappropriately.